[Craniocervical dissections: study strategies in MR imaging and MR angiography].
OBJECTIVE
To define the diagnostic efficacy of MR imaging, "time of flight" (TOF) and phase contrast (PC) MR angiography in craniocervical arterial dissections.


METHODS
The MR examinations of 16 patients with proven arterial dissections (n = 20) were retrospectively analysed by three independent readers. The MR protocol included T1w spin echo sequences with and without fat saturation (SPIR), T2w-turbo-spin echo, 2D- and 3D-TOF- and 3D-PC-MRA. The study was undertaken to assess the diagnostic sensitivity of each technique in detecting typical pathological features.


RESULTS
The overall sensitivity was best in 3D-PC-MRA; reaching 88% of all possible points. Intramural haematoma could be easily detected with T1W spin echo with fat saturation (100%). Intimal flap and lumen narrowing was best defined with 3D-TOF-MRA in 86% resp. 96% and 3D-PC-MRA in 69% resp. 97%. 3D-PC-MRA was superior to all other sequences in 5 cases of aneurysmal dissection (100%).


CONCLUSIONS
An accurate evaluation of craniocervical arterial dissections should rely on a combined protocol including T1w spin echo with fat saturation and an axial 3D-MR angiography (if possible 3D-phase contrast MRA).
Keller
E
E
Radiologische Universitätsklinik Bonn.
Flacke
S
S
Gieseke
J
J
Sommer
T
T
Brechtelsbauer
D
D
Gass
S
S
Pauleit
D
D
Textor
J
J
Schild
H H
HH
D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000792:Angiography; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014711:Vertebral Artery
Kraniozervikale Dissektionen: Untersuchungsstrategien in der MR-Tomographie und MR-Angiographie.